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The gender pay gap in the NHS

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A major source of gender pay disparity for NHS consultants arises from the Clinical Excellence Awards. Women are one third of the consultant work force but both in 2016 and 2017 received only 20% of all awards, loaded mainly by bronzes, receiving only 12% of the higher awards (ref GOV.UK/clinical excellence awards 2016 and 2017).

There is considerable regional variation. In the Department of Health, women have received half of the awards. At the other extreme is Yorkshire and Humberside where women received only 7 of the 60 awards in the last 2 years. In that region St James Leeds is the major hospital and of its 900 or so consultants 29% are women.

These statistics are crude as they do not take into account the number of years that the consultants have been eligible for an award and they overestimate the base population of men available for awards as they include the greater number of men already in receipt of an award and therefore not eligible. Numbers are also skewed by some specialties receiving a greater share of awards.

A further source of disparity is the need to gain enough points locally in order to be considered for a national award and it is likely that in this more closed system, distortions are more likely.

During my time in the NHS, I was a member of a Regional Higher Awards Committee and was aware that tribalism and personal regard and not just clinical excellence influenced the recommendations.

I believe that the fairest way of dealing with this disparity is for women to be given a set quota of awards for consideration separate from the men.

I was interested to read this article on the ongoing gender pay gap within the NHS - those of us who work within it may not be surprised. Statistics published last year (http://careers.bmj.com/careers/advice/The_gender_pay_gap%3A_female_docto...) showed that female doctors earned 34% less than their male counterparts in 2016. There are undoubtedly a number of reasons for this, not least because it is women who are the ones who take time out to go on maternity leave, and also tend to be those who go down to working less than full time (LTFT).

While this may be a choice, it is also a choice which society expects of women. And with more women than men taking time out of work for childcare, perhaps it is time for society to value the impact that this free childcare has upon its overall ability to function as it does. Perhaps if we enforced split maternity and paternity leave then giving childcare at home would become more valued. Under the new junior doctor contract women are not entitled to incremental pay increases, which means that their overall earning potential and subsequently their pensions will be less than men who do not take this time out of work. This indirect discrimination has a knock-on effect of less women being in senior positions, and therefore there being less female role models for young female doctors to look up to.

I propose that for this modern workforce to work, where 77% of the workforce is made up of women within the NHS, we would do well to remember this and to not disadvantage women who have taken time out to have children and may therefore miss out on the career progression required in order to gain job promotions... and the accompanying pay rises.